Surgical systems including adapter assemblies for interconnecting electromechanical surgical devices and end effectors

ABSTRACT

An adapter assembly for selectively interconnecting an end effector and a surgical device includes a housing configured to connect to the surgical device, a shaft assembly extending from the housing, a cable drive assembly, and a coupling member. The cable drive assembly includes a cable supported in the housing. The coupling member is secured to the cable and configured to connect to the end effector. The coupling member is movable relative to the shaft assembly in response to movement of the cable.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.15/797,250, filed Oct. 30, 2017, which claims the benefit of U.S.Provisional Patent Application Ser. No. 62/419,031, filed Nov. 8, 2016,the entire disclosure of which is incorporated by reference herein.

TECHNICAL FIELD

The present disclosure generally relates to adapter assemblies for usein surgical systems. More specifically, the present disclosure relatesto adapter assemblies to electrically and mechanically interconnectelectromechanical surgical devices and surgical end effectors.

BACKGROUND

A number of surgical device manufacturers have developed product lineswith proprietary powered drive systems for operating and/or manipulatinga surgical device. In many instances the surgical devices include apowered handle assembly, which is reusable, and a disposable endeffector or the like that is selectively connected to the powered handleassembly prior to use and then disconnected from the end effectorfollowing use in order to be disposed of or in some instances,sterilized for re-use.

Many of the existing end effectors for use with many of the existingpowered surgical devices and/or handle assemblies are driven by a linearforce. For example, end effectors for performing endo-gastrointestinalanastomosis procedures, end-to-end anastomosis procedures and transverseanastomosis procedures, each typically require a linear driving force inorder to be operated. These end effectors are not compatible withsurgical devices and/or handle assemblies that use a rotary motion todeliver power or the like.

In order to make the linear driven end effectors compatible with poweredsurgical devices and/or handle assemblies that use a rotary motion todeliver power, adapters and/or adapter assemblies are used to interfacebetween and interconnect the linear driven end effectors with thepowered rotary driven surgical devices and/or handle assemblies. Many ofthese adapter and/or adapter assemblies are complex devices includingmany parts and requiring extensive labor to assemble.

Accordingly, a need exists to develop surgical systems with adaptersand/or adapter assemblies that incorporate fewer parts, are less laborintensive to assemble, and are ultimately more economical tomanufacture.

SUMMARY

According to an aspect of the present disclosure, an adapter assembly isprovided the adapter assembly includes a housing configured to connectto a surgical device, a shaft assembly extending from the housing, acable drive assembly including a cable supported in the housing, and acoupling member secured to the cable and configured to connect to an endeffector. The coupling member is spaced from a distal end of the shaftassembly and movable relative to the shaft assembly in response tomovement of the cable.

In some embodiments, the adapter assembly may further include anactuation assembly having a drive shaft connected to a joint assembly.The joint assembly may be coupled to the coupling member and positionedto facilitate articulation of the coupling member relative to the shaftassembly. The joint assembly may include a drive pin rotatably coupledto the coupling member to transfer forces from the drive shaft throughthe coupling member. The joint assembly may include one or more jointshaving a universal joint configuration. The one or more joints mayinclude a first joint and a second joint movable relative to the firstjoint. The joint assembly may include a joint housing that supports theone or more joints therein. The joint housing may extend between thecoupling member and the shaft assembly.

In certain embodiments, the adapter assembly may further include arotation mechanism operatively coupled to the housing. The shaftassembly may define a longitudinal axis. The rotation mechanism may beconfigured to selectively lock rotational movement of the shaft assemblyabout the longitudinal axis. The rotation mechanism may include alocking ring coupled to the housing and a locking blade. The lockingblade may be engagable with the locking ring to lock rotational movementof the shaft assembly. The locking blade may be movable relative to thelocking ring to enable the shaft assembly to rotate about thelongitudinal axis.

According to another aspect of the present disclosure, a surgicalstapling apparatus is provided. The surgical stapling apparatus includesan end effector having a staple cartridge assembly and an anvilassembly, a surgical device configured to operate the end effector, andan adapter assembly for selectively interconnecting the end effector andthe surgical device.

The adapter assembly defines a longitudinal axis and includes one ormore cables, a coupling member secured to the one or more cables andselectively connectable to the end effector, and a firing assemblycoupled to the coupling member and having a universal joint. Theuniversal joint may be configured to facilitate articulation of the endeffector relative to the longitudinal axis and may be rotatable to ejectstaples from the staple cartridge assembly.

In some embodiments, the one or more cables include a plurality ofcables movable to articulate the coupling member in conjunction withcorresponding movement of the universal joint.

In certain embodiments, the coupling member may include an input couplerand the firing assembly may include a drive pin. The input coupler mayrotatably receive the drive pin therein. The coupling member may furtherinclude an output coupler configured to rotate in response to rotationof the input coupler. The end effector may include an input shaftrotatably coupled to the output coupler of the coupling member. Theoutput coupler may be configured to rotate the input shaft to effectuatean approximation of the staple cartridge assembly and the anvilassembly, and ejection of staples from the staple cartridge assembly.

In some embodiments, the end effector includes a coupling ring and aslide member. The slide member may be movable between open and closedpositions relative to the coupling ring to selectively couple the endeffector to the coupling member of the adapter assembly. The slidemember of the end effector may define a locking channel, and thecoupling member of the adapter assembly may include a pin. The pin maybe receivable within the locking channel to selective lock the couplingmember within the coupling ring. The slide member may be spring biasedtoward the closed position.

In certain embodiments, the one or more cables may include a sphericalferrule that couples the one or more cables to the coupling member. Thecoupling member may be pivotable about the spherical ferrule.

In some embodiment, the adapter assembly may further include a shaftassembly supported about the firing assembly. The shaft assembly mayextend to a crown spaced from the coupling member. The crown may defineone or more cable lumens configured to receive the one or more cablestherethrough.

According to yet another aspect of the present disclosure, a surgicalsystem is provided. The surgical system includes an end effector, asurgical device configured to operate the end effector, and an adapterassembly for selectively interconnecting the end effector and thesurgical device. The adapter assembly defines a longitudinal axis andincludes a firing assembly having first and second joints multi-axiallysupported in a joint housing. The first and second joints may beconfigured to move in sequence to facilitate articulation of the endeffector relative to adapter assembly.

Other aspects, features, and advantages will be apparent from thedescription, the drawings, and the claims that follow.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments of the disclosureand, together with a general description of the disclosure given above,and the detailed description of the embodiment(s) given below, serve toexplain the principles of the disclosure, wherein:

FIG. 1 is a perspective view of an electromechanical surgical system inaccordance with the principles of the present disclosure, theelectromechanical surgical system having an end effector shown in anunarticulated and clamped position;

FIG. 2 is a perspective view of an adapter assembly of theelectromechanical surgical system of FIG. 1 with an end effector coupledto the adapter assembly and shown in an unclamped and articulatedposition;

FIG. 3 is a perspective view of the adapter assembly shown in FIG. 2,with the end effector removed therefrom;

FIG. 4 is an enlarged, perspective view of a proximal portion of theadapter assembly shown in FIG. 3;

FIG. 5 is a cross-sectional view of the proximal portion of the adapterassembly shown in FIG. 3, as taken along section line 5-5 of FIG. 4;

FIGS. 6 and 7 are perspective views of internal components of theproximal portion of the adapter assembly shown in FIG. 3 with somecomponents thereof removed or shown in phantom for clarity;

FIG. 8 is a perspective view of the adapter assembly shown in FIG. 3with portions thereof removed or shown in phantom for clarity;

FIG. 9 is an enlarged, perspective view of the indicated area of detaildelineated in FIG. 8;

FIG. 10A is a plan view of the adapter assembly and end effector shownin FIG. 2 with the end effector disposed in an unarticulated andunclamped position;

FIG. 10B is a cross-sectional view of the adapter assembly and endeffector shown in FIG. 10A as taken along section line 10B-10B of FIG.10A;

FIGS. 11-15 are progressive views of portions of the adapter assembly ofFIG. 3 illustrating operation of a rotation mechanism of the adapterassembly;

FIGS. 16-18 are progressive views of a distal portion of a firingassembly of the adapter assembly of FIG. 3, illustrating the firingassembly in unarticulated and articulated positions;

FIG. 19 is an enlarged, perspective view of a distal portion of theadapter assembly of FIG. 3, the distal portion shown in an unarticulatedposition;

FIG. 20 is a cross-sectional view of the distal portion of the adapterassembly shown in FIG. 19, as taken along section line 20-20 of FIG. 19;

FIGS. 21-27 are various views of distal portions of the adapter assemblyshowing the adapter assembly and/or components thereof in articulatedand unarticulated positions;

FIG. 28 is an enlarged, cross-sectional view of the end effector of theelectromechanical surgical system of FIG. 1, as taken along section line28-28 of FIG. 1;

FIG. 29 is an enlarged, perspective view of a distal portion of theadapter assembly of FIG. 3 with portions shown in phantom for clarity;

FIGS. 30-32 are progressive views illustrating a reload of the endeffector of the electromechanical surgical system of FIG. 1 beingcoupled to the end effector;

FIGS. 33-37 are progressive views illustrating the end effector of theelectromechanical surgical system of FIG. 1 being coupled to the adapterassembly of FIG. 3;

FIG. 38 is a cross-sectional view of the end effector of theelectromechanical surgical system of FIG. 1, as taken along section line38-38 of FIG. 1;

FIGS. 39-42 are progressive views illustrating a clamping and a firingof the end effector of the electromechanical surgical system of FIG. 1;

FIGS. 43 and 44 are side, perspective views illustrating the endeffector of the electromechanical surgical system of FIG. 1 inarticulated positions relative to the adapter assembly of FIG. 3; and

FIG. 45 is a schematic illustration of a medical work station andoperating console in accordance with the present disclosure.

DETAILED DESCRIPTION

Electromechanical surgical systems of the present disclosure includesurgical devices in the form of powered handheld electromechanicalinstruments configured for selective attachment to different endeffectors that are each configured for actuation and manipulation by thepowered handheld electromechanical surgical instrument. In particular,the presently described electromechanical surgical systems includeadapter assemblies that interconnect the powered handheldelectromechanical surgical instruments to different end effectors foreffectuating actuation and/or manipulation of the different endeffectors.

Embodiments of the presently disclosed electromechanical surgicalsystems, surgical devices/handle assemblies, adapter assemblies, and/orend effectors/loading units are described in detail with reference tothe drawings, in which like reference numerals designate identical orcorresponding elements in each of the several views. As used herein, theterm “distal” refers to that portion of the system, assembly, device,and/or component thereof, farther from the user, while the term“proximal” refers to that portion of the system, assembly, device,and/or component thereof, closer to the user. As used herein, the term“clinician” refers to a doctor, nurse, or other care provider and mayinclude support personnel. In the following description, well-knownfunctions or construction are not described in detail to avoid obscuringthe present disclosure in unnecessary detail.

Turning now to FIGS. 1 and 2, an electromechanical surgical system, inaccordance with the present disclosure, generally referred to as 10,includes a surgical device 100 in the form of a powered handheldelectromechanical instrument, an adapter assembly 200, and a surgicalloading unit (e.g., multiple- or single-use loading unit) or endeffector 300. The surgical device 100 is configured for selectiveconnection with the adapter assembly 200, and, in turn, the adapterassembly 200 is configured for selective connection with the endeffector 300. Together, the surgical device 100 and the adapter assembly200 may cooperate to actuate the end effector 300.

The surgical device 100 of the electromechanical surgical system 10includes a handle housing 102 that supports a controller or circuitboard (not shown) and a drive mechanism 106 situated therein. Thecircuit board is configured to control various operations of thesurgical device 100. The handle housing 102 defines a cavity therein(not shown) for selective removable receipt of a rechargeable battery103 therein. The battery 103 is configured to supply power to electricalcomponents of the surgical device 100. The drive mechanism 106 withinthe handle housing 102 is configured to drive rotatable shafts 106 a-106c (and/or gear components—not shown) within the handle housing 102 inorder to perform various operations of the surgical device 100. Thedrive mechanism 106 (and/or components thereof) is operable toselectively articulate the end effector 300 about a longitudinal axis“X” defined by the adapter assembly 200 and relative to at leastportions of the adapter assembly 200; to selectively rotate the endeffector 300 about the longitudinal axis “X” and relative to the handlehousing 102; to selectively move/approximate/separate an anvil assembly310 and/or a cartridge assembly 320 of the end effector 300 with respectto one another; and/or to fire a stapling and cutting cartridge orreload 330 within the cartridge assembly 320 of end effector 300.

The handle housing 102 of the surgical device 100 includes an upperhousing portion 102 a that houses various components of the surgicaldevice 100, and a lower hand grip portion 102 b that extends from theupper housing portion 102 a. The lower hand grip portion 102 b of thehandle housing 102 may be disposed distally of a proximal-most end ofthe upper housing portion 102 a of the handle housing 102. The locationof the lower hand grip portion 102 b relative to the upper housingportion 102 a is selected to balance a weight of the surgical device 100while the surgical device 100 is connected to, or supports, the adapterassembly 200 and/or the end effector 300.

A connection portion 104 of the handle housing 102 is configured tosecure to a proximal end portion of the adapter assembly 200. Theconnection portion 104 may include a contact surface 105 in electricalcommunication with the circuit board (not shown) of the surgical device100 to control the drive mechanism 106. Each rotatable drive shaft 106a-106 c of the drive mechanism 106 can be independently, and/ordependently, actuatable and rotatable. The rotatable drive shafts, 106a, 106 b, and 106 c may be arranged in a common plane or line with oneanother (e.g., a horizontal line). As can be appreciated, any number ofrotatable drive shafts can be arranged in any suitable linear ornon-linear configuration.

The handle housing 102 of the surgical device 100 supportsfinger-actuated control buttons, rocker devices, and/or the like foractivating various functions of the surgical device 100. For example,the handle housing 102 may support actuators including an actuation pad108 in operative registration with any number of sensors 108 a thatcooperate with the actuation pad 108 and/or actuators 107 a, 107 b toeffectuate, for instance, opening, closing, rotating, articulatingand/or firing of the end effector 300. The actuation pad 108 and/or theactuators 107 a, 107 b can be disposed in electrical communication withone or more motors 103 a of the drive mechanism 106 to effectuate, forexample, rotation of the rotatable drive shafts 106 a, 106 b, and/or 106c for actuation thereof to enable movement or manipulation of one ormore of the components of the adapter assembly 200. Any of the presentlydescribed actuators can have any suitable configuration (e.g., button,knob, toggle, slide, etc.).

Reference may be made to International Application No.PCT/US2008/077249, filed Sep. 22, 2008 (Inter. Pub. No. WO 2009/039506),and U.S. Patent Application Publication No. 2011/0121049, filed on Nov.20, 2009, the entire contents of each of which are incorporated hereinby reference, for a detailed description of various internal componentsof and operation of exemplary electromechanical surgical systems, thecomponents of which are combinable and/or interchangeable with one ormore components of electromechanical surgical systems 10 describedherein.

With reference to FIGS. 2-5, the adapter assembly 200 of theelectromechanical surgical system 10 includes a housing 202 having amounting assembly 202 a at a proximal end portion thereof that couplesto a distal end portion of the surgical device 100. The housing 202further includes an outer housing 202 b rotatably coupled to themounting assembly 202 a and surrounding an inner housing 202 c. A shaftassembly 204 extends distally from the housing 202 along thelongitudinal axis “X” of the adapter assembly 200 to a coupling member206 of the adapter assembly 200 at a distal end portion of the adapterassembly 200. The coupling member 206 connects to a proximal end portionof the end effector 300.

The mounting assembly 202 a of the housing 202 supports an electricalassembly 208 with electrical components (e.g., circuit board, pins,etc.) for electrical connection to a corresponding electrical plug (notshown) disposed in the connection portion 104 of the surgical device 100(e.g., for calibration and communication of life-cycle information tothe circuit board of the surgical device 100). The mounting assembly 202a includes a mounting button 212 that is spring biased toward anextended position and is configured to be depressed downwardly to acompressed position to selectively couple the mounting assembly 202 a ofthe adapter assembly 200 to the connection portion 104 of the surgicaldevice 100. The mounting button 212 includes sloped engagement features212 a that are configured to contact internal surfaces (not shown) ofthe connection portion 104 (FIG. 1) of the handle housing 102 while themounting button 212 is in the extended position to facilitate securementof the housing 202 of the adapter assembly 200 to the connection portion104 of the handle housing 102. Depression of the mounting button 212moves the sloped engagement features 212 a (FIG. 4) away from theconnection portion 104 of the surgical device 100 so that the adapterassembly 200 can be selectively coupled and uncoupled to the surgicaldevice 100. For a detailed description of similar electrical andmounting assemblies, reference can be made to U.S. Patent ApplicationPublication No. 2015/0157320, filed Nov. 21, 2014, the entire contentsof which are incorporated by reference herein.

With reference to FIGS. 5-7, the housing 202 also supports anarticulation or cable drive assembly 220 that includes cables 240configured to manipulate the end effector 300 (FIG. 1), for example, toarticulate the end effector 300 relative to the adapter assembly 200.The cable drive assembly 220 further includes a body portion 222, afirst cable gear assembly 224, a second cable gear assembly 225, a firstworm gear drive assembly 226, and a second worm gear drive assembly 227that are rotatably supported on the body portion 222 of the cable driveassembly 220 to manipulate the cables 240.

The first cable gear assembly 224 of the cable drive assembly 220includes an upper gear 224 a, an upper capstan 224 b supported on theupper gear 224 a, and an upper fastener 224 c that couples the uppercapstan 224 b to the upper gear 224 a while the upper capstan 224 b iscoupled to an upper portion 222 a of the body portion 222 of the cabledrive assembly 220. Similarly, the second cable gear assembly 225, whichmirrors first cable gear assembly 224, includes a lower gear 225 a, alower capstan 225 b supported on lower gear 225 a, and a lower fastener225 c that couples the lower capstan 225 b to the lower gear 225 a whilethe lower capstan 225 b is coupled to a lower portion 222 b of the bodyportion 222 of cable drive assembly 220. The cables 240, which mayinclude first, second, third, and fourth cables 240 a, 240 b, 240 c, 240d (FIG. 23), are wound around respective upper and lower capstans 224 b,225 b and have proximal end portions that are fixed to the respectivecapstans 224 b, 225 b via ferrules 240 x. The cables 240 a, 240 bpositioned on the first gear assembly 224 may be positioned toeffectuate pitch (e.g., north-south direction) while the cables 240 c,240 d positioned on the second gear assembly 225 may be positioned toeffectuate yaw (e.g., east-west direction). Alternatively, the cables240 a, 240 b may be positioned to effectuate yaw while cables 240 c, 240d may be positioned to effectuate pitch.

The cable drive assembly 220 further includes proximal guide pulleys 228that are rotatably supported within the body portion 222 of the cabledrive assembly 220 and distal guide pulleys 229 that are rotatablysupported by the inner housing 202 c adjacent to the body portion 222 ofthe cable drive assembly 220. The proximal and distal guide pulleys 227,229 function to reduce friction along the cables 240 and to guide thecables 240 along the adapter assembly 200 as the cables 240 translatealong the proximal and distal guide pulleys 227, 229 while therespective proximal and distal guide pulleys 227, 229 rotate. The cables240 extend from the first and/or second cable gear assemblies 224, 225and are partially wound around the respective proximal and distal guidepulleys 228, 229 to reduce friction as the cables 240 translate alongthe guide pulleys 228, 229. One or more of the cables 240 may be wrappedin opposite directions around the proximal and/or distal guide pulleys228, 229. The cables 240 extend from the guide pulleys 228, 229 andalong a length of the shaft assembly 204. The cables 240 extend distallyto ferrules 240 y (FIG. 9) that operatively couple to a proximal endportion of the coupling member 206 to enable the coupling member 206 toselectively articulate relative to the shaft assembly 204 as the cables240 are tightened/drawn/retracted (e.g., length of cable shortened)and/or released/let out (e.g., length of cable elongated).

The first worm gear drive assembly 226 of the cable drive assembly 220is rotatably coupled to the first cable gear assembly 224 of the cabledrive assembly 220 to rotate the first cable gear assembly 224 relativeto the body portion 222 of the cable drive assembly 220. The first wormgear drive assembly 226 includes a drive coupler 226 a supported onproximal portion of a shaft member 226 b and rotatable to cause theshaft member 226 b to rotate. The drive coupler 226 a may have atri-lobed configuration and is spring biased (spring not shown) withinthe mounting assembly 202 a to enable the drive coupler 226 a toslidably move along a proximal portion of the shaft member 226 b betweencompresed and uncompressed positions to facilitate selectiveinterconnection with one of the rotatable drive shafts 106 (e.g.,rotatable drive shaft 106 c) of the surgical instrument 100. The shaftmember 226 b extends distally to a worm gear 226 c that rotates inresponse to rotation of the shaft member 226 b and is supported bybetween bearings 226 d, 226 e. The second worm gear drive assembly 227includes identical components to the first worm gear drive assembly 226except that the second worm gear drive assembly 227 of cable driveassembly 220 is rotatably coupled to the second gear assembly 225 of thecable drive assembly 220 to rotate the second cable gear assembly 225relative to the body portion 222. For a more detailed description of anexemplary cable drive assembly (or components thereof), reference can bemade to U.S. Provisional Patent Application No. 62/333,584, filed May 9,2016, the entire content of which is incorporated by reference herein.

With reference to FIGS. 8-10B, the shaft assembly 204 of the adapterassembly 200 includes an outer tube 204 a and an inner shaft assembly204 b supported by the outer tube 204 a. The inner shaft assembly 204 bincludes a proximal inner shaft 204 c that extends distally from thehousing 202 to a support ring 204 d. The proximal inner shaft 204 c ishollow. The support ring 204 d of the inner shaft assembly 204 b definesapertures 204 e therethrough that are configured to receive the cables240 to maintain the cables 240 at predetermined locations along theshaft assembly 204 (e.g., four cables positioned at circumferentiallyspaced locations such as Northerly, Southerly, Easterly, and Westerlylocations, respectively). The cables 240 may twist along the length ofthe adapter assembly 200. The inner shaft assembly 204 b furtherincludes a distal guide shaft 205 that extends distally from the supportring 204 d.

With reference to FIGS. 9, 10A, 10B, 19, and 20, the distal guide shaft205 of the shaft assembly 204 includes arms 205 a that arecircumferentially spaced relative to one another about the longitudinalaxis “X.” Each of the arms 205 a extends to a distal crown 205 b anddefines a cable lumen 205 c therethrough that is configured to receiveone of the cables 240 therein. The distal crown 205 b includes a firstprong 205 d and a second prong 205 e that together define a centralarched recess 205 f between one another. The distal guide shaft 205further defines a central bore 205 g and finger recesses 205 h that arecircumferentially spaced about distal guide shaft 205 between adjacentdistal crowns 205 b. The central bore 205 g and the finger recesses 205h are configured to slidably receive a finger spring assembly 207.

The finger spring assembly 207 is slidably movable between uncompressedand compressed positions to accommodate articulating movement of a jointhousing 282 (see FIGS. 21-25). The finger spring assembly 207 includes afinger member 207 a having fingers 207 b slidably supported in thefinger recesses 205 h of the distal guide shaft 205, and a finger spring207 c supported in the central bore 205 g against a support wall 205 iof the distal guide shaft 205. The finger spring 207 c is coupled to thefinger member 207 a to spring bias the finger member 207 a distally sothat the finger spring 207 c urges the finger assembly 207 toward theuncompressed position. Proximal portions of the finger recesses 205 hare configured to receive teeth 209 (FIG. 19) that extend distally fromthe outer tube 204 a to secure the outer tube 204 a to the distal guideshaft 205.

With reference to FIGS. 11-15, the adapter assembly 200 further includesa manual rotation mechanism 250 operatively coupled to the housing 202of the adapter assembly 200. The rotation mechanism 250 includes adepressible actuator 252 (e.g., a button or the like) mounted to theouter housing 202 b, a locking blade 254 that is movably coupled to theactuator 252 between extended and retracted positions via springs 256,and a locking ring 258 fixed around an outer surface of the innerhousing 202 c and selectively engagable with the locking blade 254 asthe locking blade 254 moves between the extended and retractedpositions. The actuator 252 defines an angled lateral recess 252 a,which may extend through opposite sides of the actuator 252, and anelongate slot 252 b. The actuator 252 may further include indicia 252 c(e.g., arrows to indicate rotation direction). The actuator 252 furtherincludes a foot 252 d that is configured to engage the locking blade 254to limit approximating movement of the actuator 252 toward the lockingblade 254.

The locking blade 254 of the rotation mechanism 250 includes one or moreposts 254 a that extend laterally therefrom and are slidable along theangled lateral recess 252 a of the actuator 252 as the actuator 252 andthe locking blade 254 move relative to one another in response tocompression and/or release of the actuator 252. The locking blade 254further includes a horn 254 b that is slidably received in the elongateslot 252 b of the actuator 252 (e.g., vertically slidable) to maintainthe locking blade 254 in alignment with the actuator 252 as the actuator252 and the locking blade 254 move relative to one another in responseto compression and/or release of the actuator 252. The locking blade 254further includes a stop flange 254 c that limits proximal movement ofthe locking blade 254 and a locking heel 254 d that selectively engagesthe locking ring 258 to prevent the housing 202 from rotating relativeto the locking ring 258. The locking blade 254 defines a rotation recess254 d therein that is positionable in registration with the locking ring258 as the locking blade 254 axially translates relative to the lockingring 258 upon compression and/or release of the actuator 252. With therotation recess 254 d disposed in registration with the locking ring258, the rotation recess 254 d is configured to enable the locking blade254 to rotate about the locking ring 258 as the outer housing 202 b ofthe housing 202 rotates about the inner housing 202 c of the housing202. The locking blade 254 further includes a support shoulder 254 fthat is selectively engageable with the foot 252 d of the actuator 252to limit approximating movement of the actuator 252 toward the lockingring 258 when the actuator 252 is depressed (e.g., actuation/compressionof the actuator 252).

The locking ring 258 of the rotation mechanism 250 includes spaced-apartteeth 258 a that define openings 258 b between adjacent teeth 258 a.Each of the openings 258 b of the locking ring 258 is configured toreceive the heel 254 d of the locking blade 245 when the actuator 252 isunactuated (FIGS. 11 and 15). While the actuator 252 is unactuated, sidesurfaces of two adjacent teeth 258 a of the locking ring 258 areconfigured to laterally contact opposing side surfaces of the heel 254 dof the locking blade 254 to prevent the outer housing 202 b of thehousing 202 from rotating (in either direction—clockwise orcounterclockwise) about the inner housing 202 c of the housing 202 tothereby prevent concomitant rotation of the shaft assembly 204 about thelongitudinal axis “X” of the adapter assembly 200.

In use, to effectuate a rotation of the end effector 300 about thelongitudinal axis “X” (FIG. 1) of the adapter assembly 200, the actuator252 of the rotation mechanism 250 is actuated or depressed radiallyinward toward the locking ring 258, compressing the springs 256 of therotation mechanism 250 so that the locking blade 254 moves distallyalong the longitudinal axis “X.” As the locking blade 254 movesdistally, the posts 254 a of the locking blade 254 slide along theangled lateral recess 252 a of the actuator 252 so that the heel 254 dof the locking blade 245 separates from the locking ring 258, wherebythe rotation recess 254 d longitudinally aligns with the locking ring258. Once the rotation recess 254 d of the locking blade 254 islongitudinally aligned with the locking ring 258, the outer housing 202b of the housing 202 is rotationally unlocked so that it can be rotatedabout the longitudinal axis “X,” to thereby rotate the shaft assembly204 and the end effector 300 about the longitudinal axis “X.”

Once a desired rotational orientation of the outer housing 202 b aboutthe circumference of the locking ring 258 is established, the actuator252 can be released so that the springs 256 urge the actuator 252 andthe locking blade 254 into their unactuated positions to rotationallylock the heel 254 d of the locking blade 254 between two adjacent teeth258 a of the locking ring 258 and fix the rotational orientation of theshaft assembly 204 and end effector 300. Each pair of adjacent teeth 258a of the locking ring 258 defines an opening 258 b that is configured toreceive the heel 254 d of the locking blade 254 such that each opening258 b is disposed at a different rotational orientation than the otheropenings 258 b so that the housing 202, the shaft assembly 204, and theend effector 300 can be simultaneously rotationally locked at differentrotational orientations about the longitudinal axis “X” (e.g., anycircumferential location).

With reference to FIGS. 5, 10B, and 16-18, the adapter assembly 200further includes a firing assembly 260 having a proximal portionsupported in the housing 202 and a distal portion that extends to thecoupling member 206. The firing assembly 260 includes a drive shaft 262that supports an input coupler 264 on a proximal portion of the driveshaft 262, and a joint assembly 266 on a distal portion of the driveshaft 262. The input coupler 264 may have a tri-lobe configuration andis supported within the mounting assembly 202 a. The input coupler 264is slidably movable along the proximal portion of the drive shaft 262and biased by a spring 268 between uncompressed and compressed positionsto facilitate selective interconnection with the rotatable drive shaft106 b of the surgical device 100. The drive shaft 262 is rotatablymounted within the housing 202 by a bearing 270 and extends centrallythrough the housing 202 to the joint assembly 266.

As seen in FIG. 16-18, a proximal portion of the joint assembly 266 ispinned to a distal portion of the drive shaft 262 via a pin 272. Thejoint assembly 266 includes a first or proximal shaft 274 that extendsdistally from the drive shaft 262 to a first joint 276. The first joint276 includes a ball 276 a and a socket 276 b that are coupled togethervia pins 276 c, 276 d. Although the socket 276 b of the first joint 276may have any suitable configuration, the socket 276 b may include ahemispherical configuration to facilitate movement of the socket 276 babout the ball 276 a. In embodiments, the first joint enables movementthrough 180°; in other embodiments, through 90°; in yet otherembodiments, through 70°. The pins 276 c, 276 d may be transverselyoriented with respect to one another (e.g., orthogonal). The ball 276 aof the first joint 276 defines an elongated slot 276 e in registrationwith the pin 276 d. The ball 276 a further defines a transverse channel276 f that is transverse to the elongated slot 276 e and rotatablyreceives the pin 276 c therein. Although any configuration iscontemplated, the transverse channel 276 f of the ball 276 a may have acircular cross-section and/or a cylindrical shape. The pin 276 d of thefirst joint 276 is pivotable within the elongated slot 276 e about along axis “A” defined by the pin 276 c (and along longitudinal axis “X”)as the pin 276 c rotates about the long axis “A” to move the socket 276b of the first joint 276 about the ball 276 a of the first joint 276, asindicated by arrow “aa.” The pin 276 c may be configured to remaincoaxial with the long axis “A” as the pin 276 c rotates about the longaxis “A.”

The joint assembly 266 further includes a second or connector shaft 278that extends distally from a distal portion of the socket 276 b of thefirst joint 276. The second shaft 278 extends distally to a second joint280 of the joint assembly 266.

The second joint 280 of the joint assembly 266 includes a ball 280 a anda socket 280 b that are coupled together by pins 280 c, 280 d. Althoughthe socket 280 b may have any suitable configuration, the socket 276 bmay include a hemispherical configuration to facilitate movement of thesocket 280 b about the ball 280 a. In embodiments, the second jointenables movement through 180°; in other embodiments, through 90°; in yetother embodiments, through 70°. The pins 280 c, 280 d may betransversely oriented with respect to one another (e.g., orthogonal).The ball 280 a of the second joint 280 defines an elongated slot 280 ein registration with the pin 280 d. The ball 280 a also defines atransverse channel 280 f that is transverse to the elongated slot 280 eand rotatably receives the pin 280 c therein. Although any configurationis contemplated, the transverse channel 280 f may have a circularcross-section and/or a cylindrical shape. The pin 280 d is linearlypivotable within the elongated slot 280 e about a long axis “B” definedby the pin 280 c as the pin 280 c rotates about the long axis “B” tomove the socket 280 b of the second joint 280 about the ball 280 a ofthe second joint 280, as indicated by arrow “bb.” The pin 280 c may beconfigured to remain coaxial with the long axis “B” as the pin 280 crotates about the long axis “B.” The second joint 280 further includes adrive pin 280 g that extends distally from the socket 280 b androtatably couples to the coupling member 206. The drive pin 280 g has anoncircular transverse cross-section and includes a flat surface 280 h.

The first and second joints 276, 280 are configured to act as one ormore universal joints to enable articulation of the end effector 300relative to the shaft assembly 204. In embodiments, the first and secondjoints collectively enable movement through 180°; in other embodiments,through 90°; in yet other embodiments, through 70° in any one direction.

With reference to FIGS. 19-29, the joint assembly 266 further includes ajoint housing 282 supported on the first and second joints 276, 280 toenable the first and second joints 276, 280 to move multi-axiallytherein (e.g., pivot and/or rotate). The joint housing 282 may includean hour-glass configuration to facilitate the multi-axial movement ofone or both joints 276, 280. The joint housing 282 includes a proximalhousing 284 that pivotably and rotatably supports the first joint 276therein, and a distal housing 286 that pivotably and rotatably supportsthe second joint 280 (and the connector shaft 278) therein. The proximalhousing 284 includes nubs 284 a that extend radially outward from anouter surface of the proximal housing 284 and are positioned inregistration with distal portions of the finger recesses 205 h of thedistal guide shaft 205, whereby the distal portions of the fingerrecesses 205 h are configured to selectively receive the nubs 284 atherein (e.g., linearly and non-rotatably) as the joint housing 282articulates relative to the distal guide shaft 205. In embodiments,joint housing, 282, in conjunction with first and second joints 276,280, permits articulating movement through 270°; in other embodiments,through 180°; in yet other embodiments, through 90°.

The nubs 284 a of the proximal housing 284 are configured to selectivelycontact respective fingers 207 b of the finger spring assembly 207 tocompress the finger member 207 a against the finger spring 207 c inresponse to articulation of the coupling member 206/joint assembly 266to enable the second joint 280 of the joint assembly 266 to pivot to amaximum articulation before the first joint 276 of the joint assembly266 begins to move toward its maximum articulation (e.g., sequentially)by virtue of a spring load imposed by the finger spring assembly 207 onthe nubs 284 a of the joint housing 282 of the joint assembly 266. Thecontact between the fingers 207 b of the finger spring assembly 207 andthe nubs 284 a of the joint housing 282 ensures that the first andsecond joints 276, 280 consistently articulate in the same order (e.g.,whereby the nubs 284 a/finger spring assembly 207 function to sequencearticulating movement of the joints 276, 280). Furthermore, the nubs 284a also function to prevent rotation between the shaft assembly 204 andthe joint housing 282 as the nubs 284 a are received between distalportions of the finger recesses 205 h of the distal guide shaft 205 ofthe shaft assembly 204. The proximal housing 284 of the joint housing282 may define any number of nubs 284 a such as four nubs 284 acircumferentially spaced about the proximal housing 284 to correspondwith four finger recesses 205 h. The distal housing 286 of the jointhousing 282 extends distally from the proximal housing 284 of the jointhousing 282 and is disposed in mirrored relation with the proximalhousing 284. The distal housing 286 defines housing slots 286 aconfigured to facilitate articulation of the coupling joint 206 aboutthe distal housing 286.

The coupling member 206 of the adapter assembly 200 includes a socketplate 288 and an attachment plate 290 that are coupled together viafasteners 292 a, 292 b. The coupling member 206 supports an inputcoupler 294, which may be centrally disposed within the coupling member206, and an output coupler 296 disposed in vertical registration with,and enmeshed with, the input coupler 294.

With specific reference to FIG. 26, the socket plate 288 defines ferrulerecesses 288 a (e.g., four) that are circumferentially spaced about aproximal portion of the socket plate 288 and are configured to receivethe ferrules 240 y secured to distal ends of the respective cables 240to secure the ferrules 240 y within the ferrule recesses 288 a. Theferrules 240 y, which may have a rounded or spherical configuration, aremulti-axially movable (e.g., rotatable and/or pivotable) within theferrule recesses 288 a to facilitate articulating movement of thecoupling member 206 relative to the shaft assembly 204. The socket plate288 includes an annular lip 288 b that extends proximally from the plate288 and circumscribes a socket 288 c that multi-axially (e.g., rotatablyand/or pivotably) receives the second joint 280 of the joint assembly266 therein and pivotably and non-rotatably receives the distal housing286 of the joint housing 282 therein. The socket plate 288 furtherincludes pins 288 d, 288 e that extend radially inward from the annularlip 288 b and are configured to slide linearly through the housing slots286 a of the distal housing 289 of the joint housing 282 to facilitatearticulating movement of the coupling member 206 about the joint housing282 while preventing rotation between the coupling member 206 and thejoint housing 282.

With continued reference to FIG. 26, the attachment plate 290 of thecoupling member 206 includes a platform 290 a having a post 290 bextending transversely therefrom (e.g., orthogonally). The attachmentplate 290 also defines a coupler chamber 290 c that rotatably supportsthe input and output couplers 294, 296, as well as the drive pin 280 gof the second joint 280 therein. The input and output couplers 294, 296are disposed within the coupler chamber 290 c in vertical registrationwith one another with the drive pin 280 g mounted within the inputcoupler 294. The input coupler 294 includes an inner surface 294 b whichmay be at least partially flat and which may correspond to an outersurface of the drive pin 280 g. The inner surface 294 b defines anon-circular opening 294 a that is configured to receive the drive pin280 g of the second joint 280 so that the drive pin 280 g and the inputcoupler 294 are positioned to rotate together in the same direction inresponse to rotation of the drive pin 280 g. The input and outputcouplers 294, 296 are positioned in the coupler chamber 290 c to rotatein opposite directions as the drive pin 280 g rotates the input coupler294 therein. The output coupler 296 also includes an inner surface thatdefines a non-circular opening 296 a. The non-circular opening 296 a mayhave a torque head configuration (e.g., star) or the like configured toreceive a proximal portion of the end effector 300 to fire the endeffector 300 upon rotation of the output coupler 296. The input andoutput couplers 294, 296 may be in the form of gears having any numberand/or configuration of teeth extending radially therefrom about arespective circumference thereof, and which may enmesh with one or moreteeth of the other of the input and output couplers 294, 296.

Turning now to FIGS. 30-33, the end effector 300, which may be in theform of single use loading unit or a multi-use loading unit, includesthe anvil assembly 310 and the cartridge assembly 320, which are pinnedtogether by pins 302. The cartridge assembly 320 is configured toselectively receive the stapling and cutting cartridge or reload 330therein. The end effector 300 further includes a coupling assembly 340mounted to a proximal end portion of the end effector 300 thatselectively couples to the coupling member 206 of the adapter assembly200.

With reference to FIGS. 33-37, the coupling assembly 340 of the endeffector 300 includes a coupling ring 342, a mounting plate 344, and aslide assembly 346. The coupling ring 342 defines a receiving chamber342 a that is configured to receive the attachment plate 290 of thecoupling member 206 therein. The mounting plate 344 is supported in thereceiving chamber 342 a and is positioned to secure the coupling ring342 to the proximal end portion of the cartridge and anvil assemblies310, 320 of the end effector by fasteners 344 a, 344 b. The mountingplate 344 further defines a shaft opening 344 c therethrough. Thecoupling ring 342 further includes an arch 342 b that extends radiallyinto the receiving chamber 342 a and defines a post receiving recess 342c. The coupling ring 342 further defines a slide channel 342 d and aspring pocket 342 e in an outer surface of the coupling ring 342. Theslide assembly 346 includes a slide member 348 that is slidablysupported in the slide channel 342 d of the coupling ring 342 between anopen position (FIG. 35) to receive the post 290 b of the coupling member206, and a closed position to secure the post 290 b against the slidemember 348 of the slide assembly 346. The slide assembly 346 furtherincludes a spring 350 that is supported within the spring pocket 342 eof the coupling ring 342, and in abutment with the slide member 348, tospring bias the slide member 348 toward the closed position (FIGS. 33,34, and 37). The slide member 348 is configured to compress the spring350 as the slide member 348 is moved from the closed position toward theopen position.

With reference to FIGS. 35-37, the slide member 348 of the slideassembly 346 includes an arm 348 a having an angled face 348 b. Theslide member 348 further defines an insertion channel 348 c inregistration with the arm 348 a and a locking channel 348 d locatedadjacent to the arm 348 a. The locking channel 348 d is disposedtransverse to the insertion channel 348 c (e.g., orthogonally). Theinsertion channel 348 c and the locking channel 348 d are configured toslidably receive the post 290 b of the coupling member 206 therein asthe slide member 348 moves toward the open position. The locking channel348 d is configured to maintain the post 290 b locked therein as theslide member 348 moves toward, and/or is disposed in, the closedposition. The post 290 b is configured to drive the slide member 348from the closed position to the open position if the post 290 b isdriven into the angled face 348 b of the slide member 348 upon insertionof the post 290 b into the insertion channel 348 c (e.g., snap-fit asopposed to manually sliding the slide member 348 open).

The slide member 348 further includes a finger recess 348 f defined inan outer surface thereof that enables the slide member 348 to bemanually slid from the closed position to the open position. While theorientation of the angled face 348 b of the arm 348 a enables the post290 b to drive the slide member 348 from the closed position to the openposition upon insertion, once the post 290 b is locked within thelocking channel 348 c, the slide member 348 must be manually moved tothe open position until the post 290 b is aligned with the insertionchannel 348 c so that the post 290 b can be removed through theinsertion channel 348 c to separate the coupling assembly 340 of the endeffector 300 from the coupling member 206 of the adapter 200. The slidemember 348 may further include indicia 348 g such as an arrow toindicate the direction for movement toward the open position.

With reference to FIGS. 38 and 39, the anvil assembly 310 includes ananvil body 312 and an anvil plate 314 supported on the anvil body 312.The anvil plate 314 includes a tissue contact surface 314 a definingfastener forming pockets (not shown) therein. The anvil plate 314 alsoincludes a knife slide surface 314 b that is disposed opposite to thetissue contact surface 314 a. The knife slide surface 314 b is spacedfrom the anvil body 312 by an upper knife passage 314 c defined betweenthe knife slide surface 314 b and the anvil body 312. The anvil plate314 defines a knife channel 314 d that extends longitudinally throughthe anvil plate 314 between the knife slide surface 314 b and the tissuecontact surface 314 a. The anvil plate 314 further includes a knife ramp314 e.

With reference to FIGS. 31, 32 and 38-40, the cartridge assembly 320includes a support body 322 defining tab slots 322 a configured tofacilitate selective attachment of the reload 330 to the support body322. The support body 322 further defines a support channel 322 bconfigured to receive the reload 330 and a lower knife passage 322 cthat is disposed in vertical registration with the support channel 322 band the upper knife passage 314 c of the anvil assembly 310. Thecartridge assembly 320 supports a lead screw 324 that is threadablycoupled to a drive beam 326. The lead screw 324 includes a drive joint328 located at a proximal end portion of the lead screw 324. The drivejoint 328 includes a ball member 328 a secured to a proximal end of thelead screw 324 and a ball socket 328 b that multi-axially receives theball member 328 a therein (e.g., rotatably and pivotably). The ballmember 328 a is pivotably and rotatably coupled to the ball socket 328 bby pins 328 c, 328 d that are transversely arranged relative to oneanother. The ball member 328 e further defines an elongate slot 328 fwithin which the pin 328 c pivots about an axis “C” defined through pin328 d, as indicated by arrow “cc.” The ball socket 328 b includes aninput shaft 328 g that extends proximally from the ball socket 328 b andis received within the noncircular opening 296 a of output coupler 296of the coupling member 206.

The drive beam 326 of the cartridge assembly 320 includes a verticalmember 326 a having an upper flange 326 b mounted to a first end of thevertical member 326 a and foot 326 c mounted to a second end of thevertical member 326 a. The foot 326 c includes a lower flange 326 dextending therefrom.

With reference to FIGS. 38, 41, and 42, the drive beam 326 of thecartridge assembly 320 is configured to translate longitudinally throughthe end effector 300 to approximate/unapproximate the anvil andcartridge assemblies 310, 320 such as by pivoting the cartridge assembly320 relative to the anvil assembly 310. While the drive beam 326 moveslongitudinally through the end effector 300, the upper flange 326 b ofthe drive beam 326 is configured to slide along the ramp 314 e and theknife slide surface 314 b of the anvil plate 314, and the lower flange326 b is configured to slide through the lower knife passage 322 c ofthe cartridge body 322. The vertical member 326 a further supports aknife 326 e.

With continued reference to FIGS. 31, 32 and 38-40, the reload 330 ofthe end effector 300 includes a cartridge body 332 having a tissuecontact surface 332 a. The tissue contact surface 332 a defineslongitudinally extending rows of fastener retention slots 332 b thatsupport rows of fasteners 334 therein that correspond to rows of thefastener forming pockets (not shown) of the anvil assembly 310. Each rowof fasteners 334 may include different sized fasteners 334 that may bearranged in ascending and/or descending order. The cartridge body 332further includes tabs 332 c that are received in the tab slots 322 a ofthe support body 322 (e.g., snap-fit). The reload 330 further defines alongitudinally extending knife slot 332 d that extends through thetissue contact surface 332 a and is configured to receive the knife 326e of the drive beam 326 therethrough. The reload 330 further supports anactuation sled 336 that is engagable with the drive beam 326 andadvanceable along the cartridge body 332 to engage pushers 338 that aresupported within the cartridge body 332. The pushers 338 are positionedto support the fasteners 334 and vertically advance through the fastenerretention slots 332 b to eject the fasteners 334 therefrom for formationagainst the fastener forming pockets of the anvil assembly 310 as theactuation sled 336 engages the pushers 338.

In use, actuation of the actuation pad 108 causes rotation of one ormore of the rotatable drive shafts 106 (e.g., clockwise and/orcounterclockwise) of surgical device 100 via the one or more motors 103a disposed within surgical device 100.

For instance, once the end effector 300 is coupled to the couplingmember 206, the actuation pad 108 can be actuated to rotate one or bothof the rotatable drive shafts 106 a, 106 c to articulate the endeffector 300 and coupling member 206 relative to the shaft assembly 204.Rotation of the rotatable drive shaft 106 c of the surgical device 100causes a corresponding rotation of the first worm gear drive assembly226 and rotation of the rotatable drive shaft 106 a of the surgicaldevice 100 causes a corresponding rotation of the second worm gear driveassembly 227. Rotation of the first and/or second worm gear driveassemblies 226, 227 causes respective first and/or second cable gearassemblies 224, 225 to draw/retract/tighten one or more of the cables240 in one direction while letting out/releasing one or more of thecables 240 in an opposite direction so that the ferrules 240 y of therespective cables 240 correspondingly draw/retract/tighten and/or letout/release the coupling member 206 so as to articulate (e.g., pitchand/or yaw) the coupling member 206 and end effector 300 relative to theshaft assembly 204 and the longitudinal axis “X” (see FIGS. 43 and 44,for example). For a more detailed description of a similar translationof cables, reference can be made to U.S. Patent Application PublicationNo. 2015/0297199, the entire content of which is incorporated byreference herein.

To clamp and fire the end effector 300, the actuation pad 108 ofsurgical device 100 is actuated to rotate the rotatable drive shaft 106b via the one or more motors 103 a (see FIG. 1) within handle housing102, and to effectuate rotation of the drive shaft 262 of the firingassembly 260 about the longitudinal axis “X” of the adapter assembly200. Rotation of the drive shaft 262 of the firing assembly 260 rotatesthe joint assembly 266 of the firing assembly 260 so that the drive pin280 g of the second joint 280 of the joint assembly 266 causes rotationof the input coupler 294 of the coupling member 206 within the couplingmember 206 (see FIG. 29). With reference to FIG. 40, rotation of theinput coupler 294 causes the output coupler 296 of the coupling member206 to rotate the drive joint 328 of the lead screw 324 so that the leadscrew 324 rotates about its axis “L” (FIG. 10B).

With reference to FIGS. 38 and 39, rotation of the lead screw 324 of thecartridge assembly 320 enables the drive beam 326 of the cartridgeassembly 320 to axially advance along the lead screw 324 by virtue of athreaded engagement between the lead screw 324 and the drive beam 326.As the drive beam 326 advances in response to rotation of the lead screw324, the drive beam 326 slides along the ramp 314 e of the anvil plate314 until the drive beam 326 approximates or clamps the anvil andcartridge assemblies 310, 320 together (e.g., to clamp tissue betweenthe anvil and cartridge assemblies 310, 320 for fastening). Continueddistal advancement of the drive beam 326 causes the drive beam 326 toengage the actuation sled 336 of the reload 330 and advance through thelongitudinal knife slot 332 d (FIG. 32) of the reload 330 whilemaintaining the anvil and cartridge assemblies 310, 320 inapproximation. Distal advancement of the drive beam 326 advances theactuation sled 336 into engagement with the pushers 338 of the reload330 to fire the fasteners 334 from the fastener retention slots 332 b ofthe reload 330 for forming against the corresponding fastener formingpockets (not shown) defined within the anvil plate 314 of the anvilassembly 310.

Reverse rotation of the lead screw 334 causes the drive beam 326 toretract so that the anvil and cartridge assemblies 310, 320unapproximate to reset the end effector 300, whereby the reload 330 canbe replaced so that the end effector 300 can then be re-fired as neededor desired.

As can be appreciated, securement of any of the components of thepresently disclosed devices can be effectuated using known fasteningtechniques such welding, crimping, gluing, etc.

The various embodiments disclosed herein may also be configured to workwith robotic surgical systems and what is commonly referred to as“Telesurgery.” Such systems employ various robotic elements to assistthe clinician and allow remote operation (or partial remote operation)of surgical instrumentation. Various robotic arms, gears, cams, pulleys,electric and mechanical motors, etc. may be employed for this purposeand may be designed with a robotic surgical system to assist theclinician during the course of an operation or treatment. Such roboticsystems may include remotely steerable systems, automatically flexiblesurgical systems, remotely flexible surgical systems, remotelyarticulating surgical systems, wireless surgical systems, modular orselectively configurable remotely operated surgical systems, etc.

The robotic surgical systems may be employed with one or more consolesthat are next to the operating theater or located in a remote location.In this instance, one team of clinicians may prep the patient forsurgery and configure the robotic surgical system with one or more ofthe instruments disclosed herein while another clinician (or group ofclinicians) remotely control the instruments via the robotic surgicalsystem. As can be appreciated, a highly skilled clinician may performmultiple operations in multiple locations without leaving his/her remoteconsole which can be both economically advantageous and a benefit to thepatient or a series of patients.

The robotic arms of the surgical system are typically coupled to a pairof master handles by a controller. The handles can be moved by theclinician to produce a corresponding movement of the working ends of anytype of surgical instrument (e.g., end effectors, graspers, knifes,scissors, etc.) which may complement the use of one or more of theembodiments described herein. The movement of the master handles may bescaled so that the working ends have a corresponding movement that isdifferent, smaller or larger, than the movement performed by theoperating hands of the clinician. The scale factor or gearing ratio maybe adjustable so that the operator can control the resolution of theworking ends of the surgical instrument(s).

The master handles may include various sensors to provide feedback tothe clinician relating to various tissue parameters or conditions, e.g.,tissue resistance due to manipulation, cutting or otherwise treating,pressure by the instrument onto the tissue, tissue temperature, tissueimpedance, etc. As can be appreciated, such sensors provide theclinician with enhanced tactile feedback simulating actual operatingconditions. The master handles may also include a variety of differentactuators for delicate tissue manipulation or treatment furtherenhancing the clinician's ability to mimic actual operating conditions.

Referring also to FIG. 45, a medical work station is shown generally aswork station 1000 and generally may include a plurality of robot arms1002, 1003; a control device 1004; and an operating console 1005 coupledwith the control device 1004. The operating console 1005 may include adisplay device 1006, which may be set up in particular to displaythree-dimensional images; and manual input devices 1007, 1008, by meansof which a person (not shown), for example a clinician, may be able totelemanipulate the robot arms 1002, 1003 in a first operating mode.

Each of the robot arms 1002, 1003 may include a plurality of members,which are connected through joints, and an attaching device 1009, 1011,to which may be attached, for example, a surgical tool “ST” supportingan end effector 1100 (e.g., a pair of jaw members) in accordance withany one of several embodiments disclosed herein, as will be described ingreater detail below.

The robot arms 1002, 1003 may be driven by electric drives (not shown)that are connected to the control device 1004. The control device 1004(e.g., a computer) may be set up to activate the drives, in particularby means of a computer program, in such a way that the robot arms 1002,1003, their attaching devices 1009, 1011 and thus the surgical tool(including the end effector 1100) execute a desired movement accordingto a movement defined by means of the manual input devices 1007, 1008.The control device 1004 may also be set up in such a way that itregulates the movement of the robot arms 1002, 1003 and/or of thedrives.

The medical work station 1000 may be configured for use on a patient “P”lying on a patient table 1012 to be treated in a minimally invasivemanner by means of the end effector 1100. The medical work station 1000may also include more than two robot arms 1002, 1003, the additionalrobot arms likewise connected to the control device 1004 andtelemanipulatable by means of the operating console 1005. A surgicalsystem, such as the presently disclosed surgical system, may also beattached to the additional robot arm. The medical work station 1000 mayinclude a database 1014 coupled with the control device 1004. In someembodiments, pre-operative data from patient/living being “P” and/oranatomical atlases may be stored in the database 1014. For a moredetailed description of exemplary medical work stations and/orcomponents thereof, reference may be made to U.S. Patent ApplicationPublication No. 2012/0116416, filed on Nov. 3, 2011, entitled “MedicalWorkstation” and PCT Application Publication No. WO2016/025132, filed onJul. 21, 2015, entitled “Robotically Controlling Mechanical AdvantageGripping, the entire contents of each of which are incorporated byreference herein.

Persons skilled in the art will understand that the structures andmethods specifically described herein and shown in the accompanyingfigures are non-limiting exemplary embodiments, and that thedescription, disclosure, and figures should be construed merely asexemplary of particular embodiments. It is to be understood, therefore,that the present disclosure is not limited to the precise embodimentsdescribed, and that various other changes and modifications may beeffected by one skilled in the art without departing from the scope orspirit of the disclosure. Additionally, the elements and features shownor described in connection with certain embodiments may be combined withthe elements and features of certain other embodiments without departingfrom the scope of the present disclosure, and that such modificationsand variations are also included within the scope of the presentdisclosure. Accordingly, the subject matter of the present disclosure isnot limited by what has been particularly shown and described.

1-20. (canceled)
 21. A surgical system comprising: a surgical devicehaving a housing and a drive mechanism supported in the housing; and anadapter housing that is mechanical coupled to the housing of thesurgical device, the adapter housing supporting a cable drive assembly,the cable drive assembly including a plurality of gears and capstans,the cable drive assembly mechanically coupled to the drive mechanism ofthe surgical device to enable the drive mechanism to provide a motiveforce sufficient to drive the cable drive assembly.
 22. The surgicalsystem of claim 21, wherein the cable drive assembly further includes acable supported in the adapter housing.
 23. The surgical system of claim22, further comprising a shaft assembly extending from the adapterhousing, and a coupling member secured to the cable, the coupling memberconfigured to connect to an end effector, the coupling member spacedfrom a distal end of the shaft assembly and movable relative to theshaft assembly in response to movement of the cable.
 24. The surgicalsystem of claim 23, further comprising an actuation assembly having adrive shaft connected to a joint assembly, the joint assembly coupled tothe coupling member and positioned to facilitate articulation of thecoupling member relative to the shaft assembly.
 25. The surgical systemof claim 24, wherein the joint assembly includes a drive pin rotatablycoupled to the coupling member to transfer forces from the drive shaftthrough the coupling member.
 26. The surgical system of claim 24,wherein the joint assembly includes at least one joint having auniversal joint configuration, a cardan joint configuration, or aconstant velocity joint configuration.
 27. The surgical system of claim26, wherein the at least one joint includes a first joint and a secondjoint movable relative to the first joint.
 28. The surgical system ofclaim 26, wherein the joint assembly includes a joint housing thatsupports the at least one joint therein and extends between the couplingmember and the shaft assembly.
 29. The surgical system of claim 23,further comprising a rotation mechanism operatively coupled to theadapter housing, wherein the shaft assembly defines a longitudinal axisand the rotation mechanism is configured to selectively lock rotationalmovement of the shaft assembly about the longitudinal axis.
 30. Thesurgical system of claim 29, wherein the rotation mechanism includes alocking ring coupled to the adapter housing and a locking blade, thelocking blade engageable with the locking ring to lock rotationalmovement of the shaft assembly, the locking blade movable relative tothe locking ring to enable the shaft assembly to rotate about thelongitudinal axis.
 31. A surgical system comprising: an end effectorincluding a staple cartridge assembly and an anvil assembly; a surgicaldevice configured to operate the end effector; and an adapter assemblyfor selectively interconnecting the end effector and the surgicaldevice, the adapter assembly defining a longitudinal axis and including:at least one cable; a coupling member secured to the at least one cableand selectively connectable to the end effector; and a firing assemblycoupled to the coupling member and having a universal joint, theuniversal joint configured to facilitate articulation of the endeffector relative to the longitudinal axis and rotatable to ejectstaples from the staple cartridge assembly.
 32. The surgical system ofclaim 31, wherein the at least one cable includes a plurality of cablesmovable to articulate the coupling member in conjunction withcorresponding movement of the universal joint.
 33. The surgical systemof claim 31, wherein the coupling member includes an input coupler andthe firing assembly includes a drive pin, the input coupler rotatablyreceiving the drive pin therein.
 34. The surgical system of claim 33,wherein the coupling member further includes an output couplerconfigured to rotate in response to rotation of the input coupler. 35.The surgical system of claim 33, wherein the end effector includes aninput shaft rotatably coupled to the output coupler of the couplingmember, the output coupler configured to rotate the input shaft toeffectuate an approximation of the staple cartridge assembly and theanvil assembly and ejection of staples from the staple cartridgeassembly.
 36. The surgical system of claim 31, wherein the end effectorincludes a coupling ring and a slide member, the slide member movablebetween open and closed positions relative to the coupling ring toselectively couple the end effector to the coupling member of theadapter assembly.
 37. The surgical system of claims 36, wherein theslide member of the end effector defines a locking channel and thecoupling member of the adapter assembly includes a pin, the pinreceivable within the locking channel to selective lock the couplingmember within the coupling ring.
 38. The surgical system of claim 36,wherein the slide member is spring biased toward the closed position.39. The surgical system of claim 31, wherein the at least one cableincludes a spherical ferrule that couples the at least one cable to thecoupling member, the coupling member pivotable about the sphericalferrule.
 40. A surgical system comprising: an end effector; a surgicaldevice configured to operate the end effector; and an adapter assemblyfor selectively interconnecting the end effector and the surgicaldevice, the adapter assembly defining a longitudinal axis and including:a firing assembly having first and second joints multi-axially supportedin a joint housing, the first and second joints configured to move insequence to facilitate articulation of the end effector relative to theadapter assembly.